The role of teleassessment in family‐centered approaches for cerebral palsy

Family-centered approaches have increasingly gained prominence in recent years as a critical component in the treatment of children with disabilities.1 Family-centered approaches in the context of children with cerebral palsy (CP) refer to a holistic framework that emphasizes the role of the family in the child's development, treatment, and overall well-being. The mentioned approaches are based on an understanding that the family is the primary support system for the child and that their involvement is crucial for effective intervention and improved outcomes. These approaches involve respecting the family's knowledge, values, and preferences, and incorporating their input into decision-making processes. Another approach that has become increasingly important in the treatment of children with CP in recent years is telerehabilitation.2 It refers to the delivery of rehabilitation services through telecommunications technology, such as video conferencing, mobile applications, and other digital platforms. Telerehabilitation can be considered to be a family-centered approach in that the primary individual delivering or accompanying the therapy is the parent or caregiver of the child. Although telerehabilitation has been utilized for many years, its popularity has surged recently. Two primary factors contribute to this increased adoption. First, the rapid advancement of technology has significantly improved accessibility, making telerehabilitation more feasible and effective. Second, the recent COVID-19 pandemic has necessitated prolonged home isolation for children with CP, highlighting the importance and convenience of remote therapeutic interventions. The primary aim of telerehabilitation is to ensure equal opportunities for children with CP who have limited access to face-to-face rehabilitation services due to geographical, economic, or health-related barriers.3 Telerehabilitation facilitates the continuation of treatment services for these children. However, a standardized and effective initial assessment is essential to develop a personalized treatment program and to measure progress accurately. This initial assessment often requires the child to visit a clinic for an in-person evaluation. Consequently, the challenge of face-to-face assessment in a clinical setting persists, and telerehabilitation does not entirely provide equal opportunities. In their study, Magalhães et al. refined the Gross Motor Family Report (GM-FR) from the parents' perspective and investigated its psychometric properties.4 The GM-FR, a family-completed, modified version of the 88-item Gross Motor Function Measure, is designed to report the gross motor function of young individuals with CP in their natural environments.5 During the refinement process, the researchers took into account the opinions of families from diverse socio-cultural backgrounds, removed items that were difficult for families to apply, and added definitions that were easier for families to understand and score. Thus, the scale is well-adapted for a family-centered approach. The GM-FR can now be used as a teleassessment outcome measure to capture family-reported functional motor skill performance in home and community settings. The fact that the GM-FR is both a parent-reported outcome measure and can be implemented remotely holds significant promise for the future of physiotherapy and rehabilitation practices for children with CP. Telerehabilitation will be fully implemented when similar studies become widespread or when clinic-based outcome measures are shown to be reliable for the remote assessment of children with CP. These advancements will overcome the barrier of face-to-face assessments in the clinic for tele-rehabilitation, thereby ensuring equal opportunities for all. Considering the increasing prevalence of technologies such as markerless motion analysis and machine learning, it is possible to envisage teleassessment becoming a crucial component of physiotherapy and rehabilitation in the near future. Not required.